Improvements in pre-hospital trauma life support in the past 20 years have led to impressive enhancement in patient survival. These achievements have come as the result of improved equipment, transport logistics, assessment/treatment protocols, and training of personnel in all levels of the care chain from the point of injury to th hospital. One of the areas that has benefited from these changes is control of hemorrhage. However, although extremity-based hemorrhage is now well addressed, the numerous hemostasis-related products and protocols that have been developed to limit/stop non-tourniquetable bleeding have not had the same widespread dissemination. A major part of this limited penetration is the diversity of products available and their high cost. This has constraine training because actual products are typically used during what can often be a difficult-to-create complex training scenario. By using recent advances in real-time, interactive, computational fluid dynamics to simulate hemodynamically controlled bleeding, SimQuest proposes to create a cost-effective training system that can allow existing training manikins to be used to provide detailed learning scenarios for a diverse range of hemostasis products. Further, since all user actions and simulation outcomes will be measured or computed, objective, quantitative performance measures can be generated to allow uniform assessment of proficiency across instructors and institutions. By expanding on the accepted paradigm of simulation-based medical training, we will provide sorely needed training that will allow these significant patient care advances to be mastered by a broad range of emergency medical response personnel. PUBLIC HEALTH RELEVANCE: The proposed simulation-based method for providing training on how to treat non-tourniquetable hemorrhage with hemostasis agents will allow an important advancement in pre-hospital trauma life support to become more widely available. By addressing the existing issues in the complexity and cost of providing this training, the innovative simulator that SimQuest will develop through this project will remove existing barriers to deployment of an important advancement in patient care, with the likely result of improving patient outcomes.